A Nurse practitioner is a licensed independent healthcare provider who practices in a variety of settings and provides nursing and medical services to individuals, families and groups in accordant with their practice specialties and state guidelines. Nurse Practitioners are also qualified to diagnose medical problems, order treatments, perform advanced procedures, prescribe medications, and make referrals for acute and chronic medical conditions, within their scope of practice.
In the United States, depending upon the state in which they work, nurse practitioners may or may not be required to practice under the supervision of a physician, frequently referred to as a “collaborative practice agreement”. However, in consideration of the shortage of primary care/internal medicine physicians, many states are eliminating or lessening the restrictive authority which allows and nurse practitioners the ability to function more autonomously (AANP 2015). …show more content…
Both Nurse Practitioners and Nurse Practitioner-students work closely with patients to monitor their health and provide care for acute and chronic illnesses. However, in the academic-clinical setting, the NP-student may only perform this function at the discretion of the supervising NP. Although work environments and responsibilities bestowed upon these distinctive nurses can be quite different, Nurse Practitioners, Registered Nurses and students is bound to the same laws and regulations governed by all states and territories that have enacted a nurse practice act (NPA). The NPA itself is insufficient to provide the necessary guidance for the nursing profession, therefore each NPA establishes a state board of nursing (BON) that has the authority to develop administrative rules or regulations to clarify or make the governing practice law(s) more specific (NCSBN
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The model discusses the impact of new regulations on education for APRN, Licensure Accreditation, Certification & Education Document, certification and practice. The model is implemented to grasp the general understanding and definition of advance practice registered nurse APRN role, inconsistencies with state by state recognition of APRN roles, and determining eligibility for APRN licensure (Consensus Model for APRN Regulation, 2015). The consensus model definition of APRN is a nurse who is educationally rounded to assume the responsibility of assessing, diagnosis, treating, teaching health promotion and disease maintenance, acquired advanced clinical knowledge and skills to provide direct patient care, has passed a national certification examination, and licensed to practice in one of the four roles (Consensus Model for APRN Regulation, 2015).
Access to quality healthcare is a growing concern in the United States especially in light of healthcare reform coverage expansions made possible by the Patient Protection and Affordable Care Act of 2010. It is estimated that 94% of all Americans will acquire healthcare coverage under the law, an increase of nearly 30 million people (King, 2011). This dramatic influx of patients into the healthcare system has projected to cause an immediate increase in added pressure on an already challenged healthcare workforce (King, 2011). Notably, at a time when healthcare demands are growing, graduate rates from medical schools remain unchanged while advanced practice registered nurse (APRN) graduate rates are rising (Cipher, Hooker, Guerra, 2006). The increased availability of APRNs, along with enhanced delivery of healthcare skills, gives the role a unique advantage in the current state of healthcare. These specialized advanced practice nurses provide services often at a patient’s first (and in some cases, primary) point of contact into the healthcare system (Brassard, 2013). Due to this, many states have started to take action to mitigate the increased healthcare system burden by enhancing the APRN’s scope of practice by broadening prescriptive authority. This has been shown to be one of the fundamental ethical avenues of increasing not only access to healthcare, but also efficiency and quality of care (Ross, 2012).
My plans after obtaining my advanced degree is to acquire licensure to practice as AGNP in the state of Texas. The Texas BON acknowledges that APN education, experiences, and competency levels vary, hence, holds individual APN accountable for knowing and practicing within their own scope of practice and competency always. The APN’s education is the grounds to their scope of practice: however, the APN can expand the scope of practice within the role and population-focus, as long as it remains within limits of the law. The Texas BON restricts the scope of practice for the APNs. The Nurse Practitioner Supervision Laws require¬¬¬¬¬ APN to work under physician supervision within seventy five mile perimeter. In addition, there is the Texas ' Nurse Practitioner Prescribing Laws which require APNs to prescribe medications under physician supervision and APNs are not allowed to prescribe schedule two drugs. All prescriptions written by the NPs must include the supervising physician 's name, address, Drug Enforcement Administration (DEA) number and phone number (Texas BON,
Even so, physicians and nurses debated the best way and extent to which the NP role should be integrated into care, as well as how far NPs could extend their scope of practice. The National Joint Practice Commission (NJPC), funded by the Kellogg foundation in 1972 was one attempt to bring nurses, physicians, and broader professional organizations together to model the collaborative behavior that made nurse-physician teams so effective at the practice level. The NJPC funded nurse Virginia Hall to investigate legal issues related to expanding nursing roles related to nurse practitioner practice. In 1974, she published Statutory Regulation of the Scope of Nursing Practice – A Critical Survey. Hall’s work was one of few nationally unifying positions to guide physicians, nurse practitioners, and state boards (Hall, 1975). The Commission also published Together, as series of exemplars that highlighted effective NP-physician collaborations (Hidgen, Offan, & Starr, 1977). Still, the American Medical Association and other physician organizations could not accept the broader scope of practice recommended by the NJPC, and it folded in 1981 after only 9 years of existence. (Fairman, 2008,
As a nurse it is our primary job to protect and promote the well being of patients throughout the health care industry. Each nurse has the responsibility to practice faithfully and to uphold all ethical values. These values are outlined and regulated by two very important entities, The Nursing Practice Acts and the Texas Board of Nursing. Nursing Practice Acts, are specific laws in each state that define a nurse’s scope of practice. These acts were first established in 1909 with the purpose of protecting public health, safety, and welfare. Their purpose is to provide rules and regulations that will protect society from unsafe and unqualified nurses. Nursing professionalism is rooted in the ethics and ...
A nurse is a health care professional who cares for ill or disabled individuals, their families and communities ensuring that they attain, maintain or recover optimum health and functioning (Crosta, 2013). There are several kinds of nurses classified depending on their education and experiences. As an example,
Sullivan-Marx, E. M., McGivern, D. O., Fairman, J. A., & Greenberg, S. A. (2010). Nurse practitioners: The evolution and future of advanced practice. (5th ed.). New York: Springer Publishing Company.
The primary barrier to nurses being able to practice at their full potential is the states varied legislation (Fairman, Rowe, Hassmiller, & Shalala, 2011). The IOM (2011) report suggests that state scope of practice regulations should model the National Council of State Boards of Nursing Model Nursing Practice act and Administrative rules to provide legal authority to practice to the accomplished level of training. The IOM (2011) report also requested a review of states laws to identify potentially anticompetitive effects that do not protect the health and safety of the public. The new recommendations are to build a common ground with interdisciplinary groups and to include a diverse coalition for the Future of Nursing: Campaign for action (IOM,
A Nurse Practitioners (NP) is an Advanced Practice Registered Nurse who has additional responsibilities for administering patient care than Register Nurses (Nurse.org). Nurse Practitioners analyze and interpret patients’ histories, symptoms, physical findings, or diagnostic information to develop appropriate diagnoses (Choices 360). They also can prescribe medications to patients according to their diagnoses and can recommend interventions to modify behavior associated with health risks. Nurse Practitioners work an average of forty hours a week, but travel is very rare for them. Cardiology Nurse Practitioners and Neonatal Nurse Practitioners are related occupations similar to Nurse Practitioner. A Cardiology Nurse Practitioner tends to patients with heart conditions and Neonatal Nurse Practitioners give medical care to newborns that are premature oar have other problems, such as low birth weight. After researching the working conditions of a Nurse Practitioner and related jobs, I began to research the outlook for the career as Nurse Practitioner along with the estimated salary (Choices
It is no secret that the current healthcare reformation is a contentious matter that promises to transform the way Americans view an already complex healthcare system. The newly insured population is expected to increase by an estimated 32 million while facing an expected shortage of up to 44,000 primary care physicians within the next 12 years (Doherty, 2010). Amidst these already overwhelming challenges, healthcare systems are becoming increasingly scrutinized to identify a way to improve cost containment and patient access (Curits & Netten, 2007). “Growing awareness of the importance of health promotion and disease prevention, the increased complexity of community-based care, and the need to use scarce human healthcare resources, especially family physicians, far more efficiently and effectively, have resulted in increased emphasis on primary healthcare renewal…” (Bailey, Jones & Way, 2006, p. 381). The key to a successful healthcare reformation is interdisciplinary collaboration between Family Nurse Practitioners (FNPs) and physicians. The purpose of this paper is to review the established role of the FNP, appreciate the anticipated paradigm shift in healthcare between FNPs and primary care physicians, and recognize the potential associated benefits and complications that may ensue.
Licensed practical nurses (LPN 's) fill an important role in modern health care practices. Their primary job duty is to provide routine care, observe patients’ health, assist doctors and registered nurses, and communicate instructions to patients regarding medication, home-based care, and preventative lifestyle changes (Hill). A Licensed Practical Nurse has various of roles that they have to manage on a day to day basis, such as being an advocate for their patients, an educator, being a counselor, a consultant, researcher, collaborator, and even a manager depending on what kind of work exactly that you do and where. It is the nursing process and critical thinking that separate the LPN from the unlicensed assistive personnel. Judgments are based
Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nursed who have received graduate-leveling nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialist when necessary. Some Nurse practitioners work under the supervision of a physician; while others run their own practices.
The American Nurses Association (ANA) developed a foundation for which all nurses are expected to perform their basic duties in order to meet the needs of the society we serve. The ANA “has long been instrumental in the development of three foundational documents for professional nursing; its code of ethics, its scope and standards of practice, ands statement of social policy.” (ANA, 2010, p. 87) The ANA defined nursing as “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and treatment of human response, and advocacy in the care of individuals, families, communities, and populations” and used to create the scope and standards of nursing practice. (ANA, 2010, p. 1) These “outline the steps that nurses must take to meet client healthcare needs.” () The nursing process, for example, is one of the things I use daily. Other examples include communicating and collaborating with my patient, their families, and my peers, and being a lifelong learner. I continually research new diagnoses, medications, and treatments for my patients. As a nurse of ...
Restraint of trade is becoming a more commonplace as nurse practitioners (NPs) attempt to expand or work within their full scope of practice (Horton, 2013). In the health system, many NPs are being restricted by physicians to oversee patients, as well as restricting the mileage with which one can collaborate with a physician. This affect patient’s care and productivity. The issue with restraint of trade is that physicians are not wanting to collaboration with NPs and the ones who do collaborate do so to meet the legal requirement only on paper. Issues with restraint of trade are that physicians are afraid NPs are going to take away their work, their income and patients (Horton, 2013). In true view, collaboration is working together with nurse